这项工作得到了成都中医药大学杏林学者研究促进项目 （MPRC2022012 和 QJJJ2023004） 的支持。

该方案已在成都中医药大学附属医院眼科批准用于临床试验伦理（伦理记录编号:KY2023001）。确保环境清洁无污染，光线充足，环境安静。获得患者的知情同意以使用和发布本文所示的数据。
1. 医生准备
<ol><li>检查患者的基本信息。确保患者符合《 近视防治指南 》中近视的诊断标准，且患有干眼症: （1） 确保患者远距离视力模糊，近视力良好，早期远视力经常波动，看远处物体时眯眼;（2） 通过屈光确定近视并确定程度。</li>
	<li>排除具有以下情况的患者: （1） 晕动病患者;（2） 皮肤溃疡;（3） 血糖控制不佳、血压控制不佳、头晕患者;（4） 凝血功能障碍和严重心功能不全患者;（5） 风湿性心脏病、先天性心脏病、肾衰竭、肝衰竭等;（6） 不配合治疗的患者。</li>
	<li>佩戴医用口罩和医用帽</li>
	<li>用肥皂水和七步洗手法洗手，保持双手干燥，并在取针前使用免洗手消毒液。 注意:手部消毒后避免触摸其他物品。手术前后必须洗手，双手必须保持清洁。</li>
</ol>2. 患者检查
<ol><li>获取患者基本信息:询问患者的姓名、性别、年龄、医生编号、身高、体重、既往病史、主诉等基本信息。</li>
	<li>测试患者的肉眼视力。<ol><li>要求患者距离视力表 5 m;遮盖眼睛的一侧。</li>
		<li>识别视力表上的"E"并检查它，直到它不再可识别。保持标签的方向从上到下。</li>
		<li>阅读视力表左侧的十进制记数法，根据视力表的读数判断患者的视力。</li>
		<li>然后使用相同的方法评估另一只眼睛。与通用视力表 （UCVA） 相比，低于 1.0 的分数被认为是近视。</li>
	</ol></li>
	<li>测试患者的干眼症评分。<ol><li>确保患者有眼睛干涩、异物感、烧灼感、疲劳、不适、眼睛发红和视力波动等主观症状之一。</li>
		<li>对照眼表疾病指数量表 （OSDI） 检查相应的情况:您在过去一周内是否出现过畏光、异物感、眼痛、眼睛刺激、视力模糊或视力丧失？ 总是出现 是 4 分， 经常出现 是 3 分， 一半时间出现 是 2 分， 有时出现 是 1 分， 没有出现 是 0 分。</li>
		<li>使用等式计算分数:0-12 是正常的;13-22 被归类为轻度干眼症;23-32 为中度干眼症;33-100 为重度干眼症。 最终比分 =<img alt="Equation 1" src="/files/ftp_upload/66727/66727eq01.jpg" style="margin: auto;"></li>
		<li>如果患者的 UCVA 评分为 <1.0 且 OSDI 为 ≥13 分，则进行下一步针刺治疗;否则，暂停针头给药。确保皮肤没有受损和溃疡。</li>
	</ol></li>
	<li>测量患者的血压。<ol><li>测量前让患者放松并安静休息 5-10 分钟。</li>
		<li>准备水银血压计;让患者坐着，双脚平放，肘部和前臂舒适地与心脏大致平行。</li>
		<li>打开血压计，将水银柱降至零。</li>
		<li>将血压计袖带系在患者上臂肘关节上方;确保一根手指仍然可以插入袖带和皮肤之间。</li>
		<li>将听诊器放在有动脉搏动的肘关节处，然后慢慢提高血压计内的压力，直到听诊器听不到血管的脉搏为止。现在慢慢放气:收缩压是听到血管脉搏的第一声，而舒张压是听不到声音的时候。</li>
		<li>如果血压正常（收缩压低于 90-140 mmHg，舒张压高于 60-90 mmHg），进行下一步针疗;否则，暂停针头应用。</li>
	</ol></li>
	<li>检测患者的脉搏率和血氧饱和度。<ol><li>准备一个夹式血氧仪，将左手或右手的食指放入夹式血氧仪的夹式中，检查夹式血氧仪中的红外灯是否开启。</li>
		<li>保持手指与夹持式血氧仪完全接触，在显示屏上显示测试进度。进入检测状态后，请保持手指稳定。</li>
		<li>显示屏上显示测试结果后，请伸出手指。显示屏顶部的 %SpO2 是血氧指数，屏幕上的 Min 是脉搏率。</li>
		<li>如果脉率正常（60-100 bpm（次/分钟）），进行下一步的针头治疗;否则，暂停针头应用。</li>
	</ol></li>
	<li>测量患者的呼吸频率。<ol><li>让患者保持安静、坐着或平躺，以保持平静的呼吸。</li>
		<li>观察患者的呼吸模式（胸式呼吸或腹式呼吸），并将手放在胸部或腹部。</li>
		<li>用手表或时钟计数，并通过观察胸部或腹腔的起伏来判断每分钟的呼吸频率。</li>
		<li>如果呼吸频率正常（12-20 次/分钟），进行下一步针刺治疗;否则，暂停针头应用。</li>
	</ol></li>
</ol>3. 穴位的识别和消毒
<ol><li>将患者平躺在治疗床上，仰卧位。摘下眼镜（如果有）以露出面部。让医生站在患者的右侧。</li>
	<li>遵循穴位定位:根据标准化穴位定位，穗竹（BL2）、余瑶（Ex-HN04）、四白（ST2）（见 图2）。<ol><li>BL2:定位在脸上，取眉毛内缘（眉毛中间，眶上切迹）的凹陷处。</li>
		<li>Ex-HN04:位于额头上，直视，瞳孔笔直向上;取眉毛的中间。</li>
		<li>ST2:定位于面部，眼睛方正，瞳孔垂直向下;以眶下孔的凹陷为例。 注意: 消毒前询问患者是否对酒精过敏。对酒精和不锈钢过敏的人不应使用它。</li>
	</ol></li>
	<li>取 75% 医用消毒酒精，在穴位喷洒 2-3 次，用一次性医用消毒棉签由内向外、从上到下擦拭;消毒部分的直径约为 2-3 厘米。等待酒精蒸发并确保操作部件干燥。</li>
</ol>4. 针灸手术
<ol><li>检查压针，确保其在保质期内，打开包装，检查压针是否完整，无损坏或变形。</li>
	<li>针灸BL2穴位:用左手拇指和食指固定皮肤，右手用镊子拿起针带，保持针头无菌，将针尖对准穴位，以45°进入皮肤，将针尖完全压入皮肤，左手按压固定带（见 图3）。<ol><li>如果接触血管，请减小针头与皮肤之间的角度，以避免针头进一步插入血管。</li>
	</ol></li>
	<li>针灸 Ex-HN04 穴位:按照步骤 4.2 中概述的程序进行操作（见 图 4）。</li>
	<li>针灸 ST2 穴位:按照步骤 4.2 中概述的程序进行操作（见 图 5）。</li>
	<li>询问患者感觉如何:轻轻按压手指 3 次以应用针头，并询问患者是否有任何酸涩、麻木、肿胀、疼痛和其他刺激。如果有任何感觉，请留下针头;如果没有感觉，调整针灸的方向，直到有感觉，然后离开针头。</li>
	<li>2 天后拔针，休息 1 天，再次涂抹上述穴位。一个疗程持续 2 周;总共进行 2 个疗程的治疗。在保留期内大约每 3 小时进行一次按压，每天 3 次，一次 ~1 分钟。</li>
	<li>取针:用左手的拇指和食指固定皮肤，右手用镊子拿起针带，取出垂直于皮肤的针头，取下后用无菌棉签按压针孔，用酒精棉签局部消毒。</li>
	<li>拔针后，将患者留在治疗室 30 分钟后再离开。</li>
	<li>疗效评价:1 个疗程（2 周）后，根据国际通用视力表 （UCVA） 测量患者的肉眼视力，并在下一个疗程前评估患者干眼评分的改善情况。</li>
</ol>

Standardizing Press Needle Treatment for Myopia with Dry Eye

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作者没有什么可披露的。

针灸作为我国古老的传统治疗方法，其疗效在漫长的发展历史中得到了验证，近年来的各种研究成果进一步证明了针灸在改善近视患者视力和干眼症状方面的有效性。这种疗法的有效性主要取决于所选择的穴位。高辉14 等人的研究证实，针灸疗法可以显着改善干眼症的症状，增加泪液分泌量。至于针灸治疗干眼症近视患者的疗效，国内已有大量临床报道得到证实。根据中医经典理论，十二经及其肤色在皮肤表面有相应的分布区域。以浅穿孔的方法，结合皮肤理论和经络穴位理论，可在皮下长时间刺激压针，达到对藏府脏腑的内部调节，改善气血，使精华得到输送的目的。近年来，随着医疗技术的创新和中医适宜技术的广泛应用，针灸在眼病中的临床应用价值越来越高15.
该公式中选择的三个穴位包括 BL2、Ex-HN04 和 ST2。BL2 、 Ex-HN04 和 ST2 是通过参考大量临床研究16,17 并将它们与研究人员的数据挖掘结果相结合来确定的。研究表明，BL2 和 ST2 是治疗干眼症的核心穴位18,19。考虑到近视患者的干眼症和发病机制，我们在上述两点的基础上增加了 ST2 分。根据藏府经络理论，ST2 穴位与脾胃功能密切相关，良好的脾胃功能可以改善干眼症的症状。现代研究表明，以上几点可以促进泪液分泌，刺激神经中枢，调节眼睛的血液循环，这支持了传统观点20.
BL2 系列 位于面部，眉毛内入时，在眶上切迹处，是足部太阳膀胱经络点。具有清热亮眸、祛风清侧、调气降气、疏通膀胱经气的作用，进而达到调节全身藏府器官的作用，使经络通畅，气血调和21。在《 针灸纲 要》中，ST2 点被记录为"主要视觉对象未知"。在现代发现 BL2 点下有滑车上神经刺激点，刺激该点可以有效改善泪液分泌。
前 HN04 位于脸上，当眼睛水平时，瞳孔与眉毛正上方相遇。它具有散风疏络、缓解疼痛和镇静神经的作用。它最早出现在元朝的《 阴海经纬 》中。这个点也是头部和面部所有阳通道的通道交换汇聚的地方，具有调节所有阳通道21 的作用。刺激余姚穴可以直接调节眼神经，促进眼睛周围的血液流动，减少无菌性炎症。
ST2 位于面部，瞳孔笔直向下，眶下孔凹陷。回足阳明胃经。李东元的《脾胃》曾记载:"九孔，五脏主，五脏所有胃气都能循环"，"胃气一虚，眼、眼、口、鼻都是病"的理论。这一点的应用反映了胃和眼睛之间的密切关系。脾胃正常运作，有序起伏，清阳气在眼内运输，养眼系统看清事物。
本研究选择的穴位覆盖着丰富的血管和神经，因此眼周穴位可以扩张局部毛细血管，加速眼周血液循环，增加血液供应22。现代研究表明，刺激眼周穴位可以抑制眼部炎症反应，保护视觉功能，改善睑板腺功能，促进泪液中脂质成分的分泌，从而延长泪膜的破裂时间，稳定泪膜，对修复角膜损伤也有一定的作用14,23。
为了促进针头的临床应用，保证疗效，尤其需要规范操作。本文的主要目的是开发一种标准化且有效的手术方案来治疗干眼症的近视。通过针灸治疗，我们有望找到手术简单、安全性高、副作用少、治疗持久的方法，以缓解近视患者干眼症的症状，提高他们的生活质量。本文的操作方法重复并优化了以前的方法 24,25,26。在前人研究的基础上，我们详细阐述了注意事项和手术护理，制定了更加规范的治疗方案，降低了不良反应的风险，并为相关研究提供了方法学参考。
这种疗法的重点是穴位的位置、针灸的手术和患者的合作。为尽可能避免不良影响，提高效率，运行过程中应注意定位的准确性。重要的是要注意，患者的合作在治疗的发展和有效性中也起着至关重要的作用。如果患者不听从医生的建议，不按照指导刺激穴位，可能无法达到预期的效果，并可能增加血肿和感染等不良反应的风险。如果患者埋针时间过长，可能会引起感染或疼痛;如果患者埋针时间过短，治疗可能无效。因此，与患者进行详细沟通、提高依从性并获得患者的合作是治疗的一些重要方面。
这种疗法有几点值得注意:手术过程中，避免摇晃或突然移动，以免增加患者的疼痛或伤害。手术完成后，将针头放入指定的容器中，避免随意丢弃，以免受伤或感染风险。如果患者在针灸过程中不能忍受疼痛或有其他异常，应停止治疗，并应及时报告相关医护人员。当遇到以下风险时，通常会采取一些对策:（1） 感染风险:针头操作可能导致交叉感染，应严格遵守操作规程，保持操作环境清洁无菌。（2） 出血风险:捏合手术可能导致出血。手术后，用棉签轻轻按压进针点，以免出血。（3） 疼痛风险:针头拔出可能会给患者带来疼痛，手术应轻柔顺畅，以减少患者的不适。
目前方法的局限性主要表现在以下三个方面:一是针灸本身不适合皮肤损伤的患者;其次，单独针灸的疗效弱于其他疗法。三是疗效评价指标有待进一步提高。为了改善治疗，必须注意以下几点。首先，为避免对患者皮肤的二次伤害，治疗前应仔细检查患者的皮肤状态，以排除皮肤损伤。接下来，为保证治疗效果，应定期提醒患者按压穴位，并监督保留针灸时间。随访研究人员可以配合耳穴压力药丸治疗。最后，为提高疗效评价的客观性，可增加泪膜破裂时间和泪液分泌试验，以评价角膜荧光素钠染色试验。
除上述不足外，本研究具有疗效持久、操作简单、成本低、不良反应少等优点，值得进一步研究和推广。对于其他治疗无效且经济负担较重的患者，本研究作为与中医一样有效的替代疗法27，为患者提供了一种有效的非药物治疗措施，以改善近视患者的眼部症状和生活质量，具有广阔的应用前景。

近视是一种屈光不正;当眼睛处于放松的调整状态时，平行光线穿过屈光视网膜后聚焦在视网膜前方，从而在视网膜上产生清晰的图像，这称为近视。这种疾病的主要表现是近处物体的清晰视力和远处物体的模糊视力1。当正常的眼睛适应到松弛状态时，来自 5 m 外的平行光线穿过眼睛的屈光系统，焦点落在视网膜上，形成清晰的图像。但是，当近视患者看到 5 m 外的远处物体时，平行光线穿过眼球的屈光系统后会聚焦在视网膜前方，因此视力会变得模糊。如果观察 5 m 以内的近处物体，平行光线穿过眼球的屈光系统后会聚焦在视网膜上，效果会更清晰。由于近年来社会经济环境的快速变化，电子屏幕的广泛使用，以及精细化的眼睛使用方法的增加，近视的发病率迅速增加，并呈现年轻化的趋势，对社会健康产生了严重影响。
据统计，到 2050 年，全球近视人数将达到近 50 亿。随着电脑和智能手机的普及，加上之前新型冠状病毒爆发的影响，越来越多的近视患者开始出现干眼症状2。中国有近 4 亿人患有干眼症，近视干眼症的患病率明显高于正视和远视，近视青少年干眼症的发生率约为 20%。泪液不足和泪膜不稳定是导致干眼症的关键因素，近视患者眼睛伸长过程中角膜的变化和眼睑空间的增加会导致泪膜分布不均匀，导致泪膜稳定性下降，从而增加干眼症的风险。
干眼症的特征是泪膜不平衡和眼睛不适。是角膜结膜干燥的慢性炎症反应，主要表现为对外界环境敏感、泪液不足、眼感异物。可导致角膜结膜病变和视力障碍，进而影响患者的生活质量和视力3。干眼症的病因很复杂;主要原因是泪液的质量、数量和动力学异常，导致泪膜不稳定或眼表微环境失衡。疾病的具体起病与患者的眼表泪膜渗透压变化、免疫炎症反应、泪膜过度氧化、感觉神经麻痹和细胞凋亡有关，病理过程涉及 MAPK、NF-κB、Wnt、TLR、PI3K/AKT 等信号通路 4,5。
中医认为，近视患者干眼症的主要发病机制是肝肾功能不全。在 黄帝的内经苏温中记载"五脏六腑渗入眼内"，由此可见内脏功能障碍、滋润眼睛的液体产生不足或输液不良是重要的病原。 银海精微 明确指出:"泪水少负责肝肾虚"——肝脏的主要血液是眼睛的外部，肝血充足，肝气调理，将细微物质注入眼表以产生泪水。肾脏的主要水是体液的源头，肾充足，肾气充盈，全身源头充足。肝肾精华和血液是同源且相互关联的，因此肝肾功能不全是一个重要的发病机制6。目前，干眼症的临床治疗主要以人工泪液、维生素、神经生长因子和热脉冲疗法为主，短期效果良好，但长期效果仍然有限。中医治疗以中医内服为主，针灸、热敷熏蒸、耳压丸等。疗效持久性好，但手术较复杂，患者依从性不强。
压针是一种皮内针灸，在临床上应用广泛，主要用于治疗面瘫、失眠、痛经等疾病，近年来逐渐扩展到眼科疾病，具有疗效持久、操作简便、成本低、患者依从性好等特点7.具体来说，将一根特殊的小针（0.2-0.3 厘米长）插入并固定在穴位区域或皮下进行长时间埋葬。埋针时无需立即产生空气感，只有埋针后才能调节空气。本疗法结合了穴位理论和中医皮肤理论，采用"久静不动"的古老理念，结合传统针灸和埋线的优点，对皮肤进行长时间的持续刺激，达到防病的目的。
压针可以改善肉眼远视力，改善视觉疲劳状态，减少屈光，延缓近视患者的轴向生长，这已被临床研究证实 8,9,10。按压针可以改善干眼症，在改善干眼症患者泪膜稳定性、泪液分泌和角膜上皮损伤程度方面优于单独使用透明质酸钠滴眼液 11,12,13。按压针联合耳压豆、中医雾化熏蒸、按摩治疗干眼症的效果更为显著，这可能与调控MAPK、NF-kB、Wnt、TLR、PI3K/AKT等多条信号通路有关。
基于中医穴位和皮肤虫理论，本研究采用压针治疗（图 1），旨在改善干眼症症状、改善视觉功能和生活质量。按压针是一种持久、易于操作且价格低廉的中医治疗方法。综上所述，有必要提出一个关于如何正确操作针灸治疗干眼症近视的标准方案。本文介绍了如何正确使用压针治疗近视患者的干眼症。

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press needle: a traditional chinese medicine therapy for myopia patients with dry eye

大多数近视患者患有干眼症，这已被证明会对近视患者的眼部症状、近视进展和生活质量产生不利影响。针刺已被证明可有效缓解近视和干眼症患者的症状。压针是一种持久、易于操作且价格低廉的中医治疗方法。针头插入的标准做法对于治疗近视和干眼症非常重要。具体步骤包括选择合适的穴位，用合适的针刺穿，固定在穴位皮肤或皮下，埋 2 天，休息 1 天;治疗过程持续 2 周。具体来说，评估了以下指标: 未矫正视力和眼表疾病指数。本文将解释如何规范按压针在治疗近视和干眼症中的操作。

在本研究中，共有 8 名符合标准的患者参加并完成了试验，在此过程中没有一人出院或被排除在外。OSDI 和 UCVA 评分用作该试验的主要评价指标，数据来自患者在治疗前后完成的量表评分。使用配对 t 检验比较治疗前后的自我控制。
表 1 比较了患者治疗前后的 OSDI 评分。将 OSDI 评分分为轻度症状≤ 21~45 分为中度症状，≥46 分为重度症状。治疗后患者 OSDI 评分显著低于治疗前患者，差异有统计学意义 （P < 0.05）。说明治疗有效，但评分仍高于 46 分，说明效果有待提高，治疗时间更长。
患者治疗前后 UCVA 评分的比较如 表 2 所示。国际标准视力表用于测量视力，即十进制记录法。治疗后左眼 UCVA 评分低于治疗前，差异有统计学意义 （P < 0.05）。治疗前后右眼 UCVA 评分差异无统计学意义 （P > 0.05）。近视发展时间长，短期针灸治疗可以改善一些视力，但要明显改善视力比较困难，治疗时间更长。
以上研究表明，针灸可以有效改善患者的干眼症状。肉眼视力可能会有所改善。
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/66727/66727fig01.jpg"> 图 1:压针的图像。这里使用了尺寸为 0.22 mm x 1.5 mm 的压针。 （A） 一板压针，包括 10 根压针，总长约 5 厘米，宽约 2 厘米;左下角是一根撕裂的压针。（B） 针面朝上按压针头，针体从中间突出约 1.5 毫米，用于刺穿皮肤;肉色部分是一条胶带，长约 1 厘米，宽约 1 厘米，用于固定针体。（C） 胶带朝上的压针，针身隐藏在下方，胶带长约 1 厘米，宽约 1 厘米。将针头压入皮肤并向上粘贴，以确保表面光滑且无损伤。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/66727/66727fig01large.jpg" target="_blank">请单击此处查看此图的较大版本。</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/66727/66727fig02.jpg"> 图 2:穴位位置示意图。 左边是一张手绘地图，显示了针灸治疗中使用的穴位。右侧是模型穴位位置图，展示了穴位在真人脸上的位置。两张图片用于比较参考，以演示穴位定位的视觉表示。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/66727/66727fig02large.jpg" target="_blank">请单击此处查看此图的较大版本。</a>
<img alt="Figure 3" class="xfigimg" src="/files/ftp_upload/66727/66727fig03.jpg"> 图 3:针灸 BL2 穴位手术。 该图说明了将针头插入 BL2 的具体定位和操作。这张图只展示了一个穴位，另一个穴位是相同的技术。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/66727/66727fig03large.jpg" target="_blank">请单击此处查看此图的较大版本。</a>
<img alt="Figure 4" class="xfigimg" src="/files/ftp_upload/66727/66727fig04.jpg"> 图 4:针灸 Ex-HN04 穴位手术。 该图说明了将针头插入 Ex-HN04 的具体定位和操作。这张图只展示了一个穴位，另一个穴位是相同的技术。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/66727/66727fig04large.jpg" target="_blank">请单击此处查看此图的较大版本。</a>
<img alt="Figure 5" class="xfigimg" src="/files/ftp_upload/66727/66727fig05.jpg"> 图 5:针灸 ST2 穴位手术。 该图说明了将针头插入 ST2 的具体定位和操作。这张图只展示了一个穴位，另一个穴位是相同的技术。 <a href="https://www-jove-com.remotexs.ntu.edu.sg/files/ftp_upload/66727/66727fig05large.jpg" target="_blank">请单击此处查看此图的较大版本。</a>
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always"><tbody><tr><td></td>
			<td>平均值</td>
			<td>标准差</td>
			<td>均值差值</td>
			<td>t•</td>
			<td>p•</td>
		</tr><tr><td>治疗前</td>
			<td>64.49</td>
			<td>5.85</td>
			<td rowspan="2">17.67</td>
			<td rowspan="2">4.092</td>
			<td rowspan="2">0.005**</td>
		</tr><tr><td>治疗后</td>
			<td>46.82</td>
			<td>11.49</td>
		</tr><tr><td colspan="6">* p < 0.05 ** p < 0.01</td>
		</tr></tbody></table>表 1:治疗前后的 OSDI 评分。 治疗后 8 例患者的 OSDI 评分显著低于治疗前患者，差异有统计学意义 （P < 0.05）。N=8。
<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always"><tbody><tr><td colspan="2"></td>
			<td>平均值</td>
			<td>标准差</td>
			<td>均值差值</td>
			<td>t•</td>
			<td>p•</td>
		</tr><tr><td colspan="2">治疗前（左眼）</td>
			<td>0.34</td>
			<td>0.15</td>
			<td rowspan="2">-0.04</td>
			<td rowspan="2">-2.497</td>
			<td rowspan="2">0.041*</td>
		</tr><tr><td colspan="2">治疗后（左眼）</td>
			<td>0.38</td>
			<td>0.17</td>
		</tr><tr><td colspan="2">治疗前（右眼）</td>
			<td>0.32</td>
			<td>0.23</td>
			<td rowspan="2">-0.04</td>
			<td rowspan="2">-2.036</td>
			<td rowspan="2">0.081</td>
		</tr><tr><td colspan="2">治疗后（右眼）</td>
			<td>0.36</td>
			<td>0.23</td>
		</tr><tr><td colspan="4">* p < 0.05 ** p < 0.01</td>
			<td></td>
			<td></td>
			<td></td>
		</tr></tbody></table>表 2:治疗前后的 UCVA 评分。 治疗后左眼 UCVA 评分低于治疗前，差异有统计学意义 （P < 0.05）。治疗前后右眼 UCVA 评分差异无统计学意义 （P > 0.05）。N=8。

Read this Scientific Article Protocol about Author Spotlight: Exploring Press Needle Efficacy and Underlying Molecular Pathways at JoVE.com

Author Spotlight: Exploring Press Needle Efficacy and Underlying Molecular Pathways

在这里，我们提出了一种方案，以标准化针灸治疗干眼症近视的操作。

压针:干眼症近视患者的中医疗法

Most patients with myopia have dry eye, which has been shown to adversely affect ocular symptoms, myopia progression, and quality of life in patients with ...

我们的研究重点是使用中医预防和治疗眼病。具体来说，我们正在制定治疗近视和干眼症的标准手术计划。按压针可以提高干眼症患者泪膜、泪液分泌和角膜雅典损伤的稳定性，比单独使用钠、高神经率滴眼液更好。可能与 MAPK、LFP、B、WNT、TLR、PI3、KAKT 和其他信号通路的调节有关。我们观察到针灸治疗后近视患者的干眼症状有显着改善，并导致某些病例的视力得到改善。

press-needle-traditional-chinese-medicine-therapy-for-myopia-patients

Nanyang Technological University

Research

JoVE Journal

Medicine

Press Needle: A Traditional Chinese Medicine Therapy for Myopia Patients with Dry Eye

1.1K 次观看.  Eye School of Chengdu University of Traditional Chinese Medicine. 我们的研究重点是使用中医预防和治疗眼病。具体来说，我们正在制定治疗近视和干眼症的标准手术计划。按压针可以提高干眼症患者泪膜、泪液分泌和角膜雅典损伤的稳定性，比单独使用钠、高神经率滴眼液更好。可能与 MAPK、LFP、B、WNT、TLR、PI3、KAKT 和其他信号通路的调节有关。我们观察到针灸治疗后近视患者的干眼症状有显着改善，并导致某些病例的视力得到改?...

视频: Author Spotlight: Exploring Press Needle Efficacy and Underlying Molecular Pathways

Scleral Cross-linking Using Riboflavin and Ultraviolet-A Radiation for Prevention of Axial Myopia in a Rabbit Model

Myopic individuals, especially those with severe myopia, are at higher-than-normal risk of cataract, glaucoma, retinal detachment and chorioretinal abnormalities. In addition, pathological myopia is a common irreversible cause of visual impairment and blindness1-3. Our study demonstrates the effect of scleral crosslinking using riboflavin and ultraviolet-A radiation on the development of axial myopia in a rabbit model. The axial length of the eyeball was measured by A-scan ultrasound in New Zealand white rabbits aged 13 days (male and female). The eye then underwent 360&#176; conjunctival peritomy with scleral crosslinking, followed by tarsorrhaphy. Axial elongation was induced in 13 day-old New Zealand rabbits by suturing their right eye eyelids (tarsorrhaphy). The eyes were divided into quadrants, and every quadrant had two scleral irradiation zones, each with an area of 0.2 cm&#178; and a radius of 4 mm. Crosslinking was performed by dropping 0.1% dextran-free riboflavin-5-phosphate onto the irradiation zones 20 sec before ultraviolet-A irradiation and every 20 sec during the 200 sec irradiation time. UVA radiation (370 nm) was applied perpendicular to the sclera at 57 mW/cm&#178; (total UVA light dose, 57 J/cm&#178;). Tarsorrhaphies were removed on day 55, followed by repeated axial length measurements. This study demonstrates that scleral crosslinking with riboflavin and ultraviolet-A radiation effectively prevents occlusion-induced axial elongation in a rabbit model.

We demonstrate the effect of scleral crosslinking with riboflavin and UVA on an axial elongation rabbit eye. Axial elongation was induced in 13 day-old New Zealand rabbits (male and female) by suturing their right eye eyelids (tarsorrhaphy).

巩膜交联兔模型使用核黄素和紫外辐射的轴性近视防治

Myopic individuals, especially those with severe myopia, are at higher-than-normal risk of cataract, glaucoma, retinal detachment and chorioretinal ...

科研

医学

Second Harmonic Generation Signals in Rabbit Sclera As a Tool for Evaluation of Therapeutic Tissue Cross-linking (TXL) for Myopia

Methods to strengthen tissue by introducing chemical bonds (non-enzymatic cross-linking) into structural proteins (fibrillar collagens) for therapy include photochemical cross-linking and tissue cross-linking (TXL) methods. Such methods for inducing mechanical tissue property changes are being employed to the cornea in corneal thinning (mechanically weakened) disorders such as keratoconus as well as the sclera in progressive myopia, where thinning and weakening of the posterior sclera occurs and likely contributes to axial elongation. The primary target proteins for such tissue strengthening are fibrillar collagens which constitute the great majority of dry weight proteins in the cornea and sclera. Fortuitously, fibrillar collagens are the main source of second harmonic generation signals in the tissue extracellular space. Therefore, modifications of the collagen proteins, such as those induced through cross-linking therapies, could potentially be detected and quantitated through the use of second harmonic generation microscopy (SHGM). Monitoring SHGM signals through the use of a laser scanning microscopy system coupled with an infrared excitation light source is an exciting modern imaging method that is enjoying widespread usage in the biomedical sciences. Thus, the present study was undertaken in order to evaluate the use of SHGM microscopy as a means to measure induced cross-linking effects in ex vivo rabbit sclera, following an injection of a chemical cross-linking agent into the sub-Tenon&#39;s space (sT), an injection approach that is standard practice for causing ocular anesthesia during ophthalmologic clinical procedures. The chemical cross-linking agent, sodium hydroxymethylglycinate (SMG), is from a class of cosmetic preservatives known as formaldehyde releasing agents (FARs). Scleral changes following reaction with SMG resulted in increases in SHG signals and correlated with shifts in thermal denaturation temperature, a standard method for evaluating induced tissue cross-linking effects.

Second Harmonic Generation Signals in Rabbit Sclera As a Tool for Evaluation of Therapeutic Tissue Cross-linking TXL for Myopia

This protocol describes techniques for evaluating chemical cross-linking of the rabbit sclera using&#160;second harmonic generation imaging and differential scanning calorimetry.

兔巩膜二次谐波信号作为治疗组织交叉连接 (txl-) 评价近视的工具

Methods to strengthen tissue by introducing chemical bonds (non-enzymatic cross-linking) into structural proteins (fibrillar collagens) for therapy ...

Intense Pulsed Light for the Treatment of Dry Eye Owing to Meibomian Gland Dysfunction

Dry eye disease (DED) is an increasingly common condition and one of the most common complaints of patients. The vast majority of DED is caused by the so-called &#34;evaporative&#34; subtype, that is mainly caused by meibomian gland dysfunction (MGD). Intense pulsed light (IPL) devices employ high intensity pulses of polychromatic lights with a broad range of wavelength (515-1200 nm). IPL treatment has been utilized for years in the field of dermatology, and then its use was applied to ophthalmology for the treatment of MGD. Recently, a new device employing IPL was specifically designed for the periocular application. This procedure determines the thermal selective coagulation and ablation of superficial blood vessels and telangiectasias of the eyelids skin, reducing the release of inflammatory mediators and tear cytokines levels, and improving meibomian glands outflow. IPL treatment is noninvasive and easy to perform, lasts for only a few minutes and can be conducted in an office setting. In the present study, 19 patients underwent 3 sessions of IPL treatment. After treatment, both mean noninvasive break-up time and lipid layer thickness grade significantly increased, as a result of an improvement of tear film stability and quality, respectively. Conversely, no statistically significant changes were found for meibomian gland loss and tear osmolarity. Furthermore, the vast majority of the treated patients (17/19; 89.5% of the total) perceived an improvement of their ocular discomfort symptoms after IPL treatment. Although IPL treatment provides an improvement of both ocular surface parameters and ocular discomfort symptoms after one cycle of three sessions, regular repeated treatments are usually required to maintain the persistence over the time of its beneficial effects.

Dry eye disease is an increasingly common condition, which strongly impair patients&#39; life quality. Recently, a new device employing intense pulsed light, specifically designed for the periocular area, has been shown to improve tear film stability and ocular discomfort symptoms in dry eye disease owing to meibomian gland dysfunction.

梅博米安腺体功能障碍治疗干眼症的强脉冲光

Dry eye disease (DED) is an increasingly common condition and one of the most common complaints of patients. The vast majority of DED is caused by the ...

Preparation Of Gushukang (GSK) Granules for In Vivo and In Vitro Experiments

Traditional Chinese herbal medicine plays a role as an alternative method in treating many diseases, such as postmenopausal osteoporosis (POP). Gushukang (GSK) granules, a marketed prescription in China, have bone-protective effects in treating POP. Before administration to the body, one standard preparation procedure is commonly required, which aims to promote the release of active constituents from raw herbs and enhance the pharmacological effects as well as therapeutic outcomes. This study proposes a detailed protocol for using GSK granules in in vivo and in vitro experimental assays. The authors first provide a detailed protocol to calculate the animal-appropriate dosages of granules for in vivo investigation: weighing, dissolving, storage, and administration. Second, this article describes protocols for micro-CT scanning and the measurement of bone parameters. Sample preparation, protocols for running the micro-CT machine and quantification of bone parameters were evaluated. Third, serum-containing GSK granules are prepared, and drug-containing serum is extracted for in vitro osteoclastogenesis and osteoblastogenesis. GSK granules were intragastrically administered twice per day to rats for three consecutive days. Blood was then collected, centrifuged, inactivated, and filtered. Finally, serum was diluted and used for performing osteoclastogenesis and osteoblastogenesis. The protocol described here can be considered a reference for pharmacological investigations of herbal prescription medicines, such as granules.

Preparation Of Gushukang GSK Granules for In Vivo and In Vitro Experiments

This article provides a detailed protocol for preparing a working solution of Gushukang granules for animal studies and GSK granule containing serum for in vitro experiments. This protocol can be applied to pharmacological investigations of herbal medicines as well as prescriptions for both in vivo and in vitro experiments.

古树康 (GSK) 颗粒的制备,用于 Vivo 和体外实验

Traditional Chinese herbal medicine plays a role as an alternative method in treating many diseases, such as postmenopausal osteoporosis (POP). Gushukang ...

Platelet-Rich Plasma Lysate for Treatment of Eye Surface Diseases

Various ocular surface diseases are treated with blood-derived eye drops. Their use has been introduced in clinical practice because of their metabolite and growth factor content, which promotes eye surface regeneration. Blood-based eye drops can be prepared from different sources (i.e., whole blood or platelet apheresis donation), as well as with different protocols (e.g., different dilutions and freeze/thaw cycles). This variability hampers the standardization of clinical protocols and, consequently, the evaluation of their clinical efficacy. Detailing and sharing the methodological procedures may contribute to defining common guidelines. Over the last years, allogenic products have been diffusing as an alternative to the autologous treatments since they guarantee higher efficacy standards; among them, the platelet-rich plasma lysate (PRP-L) eye drops are prepared with simple manufacturing procedures. In the transfusion medicine unit at AUSL-IRCCS di Reggio Emilia, Italy, PRP-L is obtained from platelet-apheresis donation. This product is initially diluted to 0.3 x 109 platelets/mL (starting from an average concentration of 1 x 109 platelets/mL) in 0.9% NaCl. Diluted platelets are frozen/thawed and, subsequently, centrifuged to eliminate debris. The final volume is split into 1.45 mL aliquots and stored at &#8722;80 &#176;C. Before being dispensed to patients, eye drops are tested for sterility. Patients may store platelet lysates at &#8722;15 &#176;C for up to 1 month. The growth factor composition is also assessed from randomly selected aliquots, and the mean values are reported here.

Platelet lysates represent an emerging tool for the treatment of ocular surface diseases. Here, we propose a method for the preparation, dispensation, storage, and characterization of platelet lysate collected from platelet donors.

富血小板血浆裂解物用于治疗眼表疾病

Various ocular surface diseases are treated with blood-derived eye drops. Their use has been introduced in clinical practice because of their metabolite ...

<meta charset="utf8"></head><body>评估眼表疾病中角膜神经的健康状况

Corneal Sensitivity Testing Procedure for Ophthalmologic and Optometric Patients

The cornea is the most densely innervated structure in the human body, making it one of the most sensitive tissues. Changes in corneal nerve sensitivity can be observed in several ocular surface diseases. Nerve sensitivity may be increased, as is often seen in patients with a neuropathic component to ocular pain, or decreased, as is seen in patients with neurotrophic keratitis. Corneal sensitivity testing involves assessing a patient's reaction to brief corneal stimulation, yields insight into the health of the corneal nerves, and provides diagnostic value for evaluating the health of the nerves and the interplay with the ocular surface. Currently, there is limited published guidance on how to conduct corneal sensitivity testing in a clinical setting. This article presents a protocol for testing corneal sensitivity using easy-to-use, low-cost materials that are readily accessible to eye care providers (either a cotton swab, a piece of dental floss, or a finely tapered tissue). This protocol allows for qualitative assessment of corneal sensitivity in which responses to corneal stimulation are rated from 0 (no response) to 3 (hypersensitive response). This test can be performed quickly (in approximately 30 s). Given its diagnostic value and accessibility, corneal sensitivity testing should be included as part of the standard eye examination for any patient undergoing an ocular surface examination.

<meta charset="utf8"></head><body> 作者聚焦:在临床环境中建立实用且经济高效的角膜敏感性检测方案

Corneal sensitivity testing provides insight into the health of the corneal nerves and helps diagnose ocular surface diseases. We present a concise protocol to qualitatively assess corneal sensitivity that can be readily used by eye care providers across clinical settings.

眼科和验光患者的角膜敏感性测试程序

The cornea is the most densely innervated structure in the human body, making it one of the most sensitive tissues. Changes in corneal nerve sensitivity ...

<meta charset="utf8"></head><body>准分子激光多焦点双非球面消融术用于老花眼矫正

Correction of Presbyopia by Monocular Bi-Aspheric Ablation Profile

The study aims to evaluate visual acuity and objective visual quality before and after the monocular bi-aspheric ablation profile for correction of presbyopia surgery. This prospective self-control study included 20 cases and 38 eyes of patients who underwent monocular bi-aspheric ablation profile correction of myopia with presbyopia at the Eye Hospital of Shandong University of Traditional Chinese Medicine from January 2023 to January 2024. These patients were selected for observation, and each patient's preoperative and postoperative uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), corrected distance visual acuity (CDVA), spherical aberration (SA) (within 6 mm), horizontal and vertical coma (within 6 mm), and corneal aspheric index (Q-value) (within 6 mm) were evaluated. Statistical data analysis was performed at different time points before and after the operation. There were statistically significant differences in UDVA between dominant and non-dominant eyes before and after surgery (Z = -3.784, p &lt; 0.001; Z = -3.817, p &lt; 0.001). Post-operatively, 90% of the non-dominant eyes achieved UNVA of J1 and above, and 95% of the bilateral eyes achieved UNVA of J1 and above. Significant differences were found in the SA of the dominant eyes, which showed a positive increase (Z= -3.784, p &lt; 0.001); however, compared with the dominant eye, the SA of the non-dominant eye was negatively increased, but the difference was not statistically significant (p = 0.08). There was a significant difference in the vertical coma of the dominant eye before and after the operation, but there was no significant difference in non-dominant eyes. There was no significant difference in the change of binocular horizontal coma before and after the operation. There were significant changes in the Q value of both eyes before and after the operation (Z = -3.923, p &lt; 0.001; Z = -3.51, p &lt; 0.001). After the monocular bi-aspheric ablation profile, the cornea of the non-dominant eye showed a prolate shape, negative SA increased, and the UDVA and UNVA improved after the operation.

<meta charset="utf8"></head><body>作者聚焦:老花眼屈光手术矫正的进展和探索术后视力

This article provides a step-by-step guide to correcting presbyopia with a monocular bi-aspheric ablation profile.

通过单眼双非球面消融剖面矫正老花眼

The study aims to evaluate visual acuity and objective visual quality before and after the monocular bi-aspheric ablation profile for correction of ...

压针:干眼症近视患者的中医疗法

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巩膜交联兔模型使用核黄素和紫外辐射的轴性近视防治

兔巩膜二次谐波信号作为治疗组织交叉连接 (txl-) 评价近视的工具

梅博米安腺体功能障碍治疗干眼症的强脉冲光

古树康 (GSK) 颗粒的制备,用于 Vivo 和体外实验

富血小板血浆裂解物用于治疗眼表疾病

眼科和验光患者的角膜敏感性测试程序

眼科和验光患者的角膜敏感性测试程序

眼科和验光患者的角膜敏感性测试程序

通过单眼双非球面消融剖面矫正老花眼

通过单眼双非球面消融剖面矫正老花眼